Wiese, Lisa

Obstructive sleep apnea affects an estimated 936 million people worldwide (Pivetta, 2021). Untreated OSA can lead to adverse metabolic, cardiovascular, and neurocognitive consequences, possibly reducing one’s lifespan. Education and screening can spread awareness among a community which typically has limited access to resources and may promote early recognition and treatment.
In a Christian-based prison reentry residential community, a pre-test survey was provided to a total sample of 19 participants to measure baseline knowledge of OSA. After administration of the pre-survey, education was provided in a group setting, using a detailed brochure the DNP student created. After participants read through the material and questions were answered, the post-survey was administered to measure if knowledge regarding OSA increased. Screening using the STOP-Bang questionnaire occurred after the post-surveys. The DNP student followed up with participants found to be at high risk for OSA patients over a 3-month period. A 37% of participants scored high risk for OSA, 37% scored intermediate risk, and 26% scored low risk. The p-value calculated to measure pre-and-post OSA knowledge using the survey total score was statistically significant (< .001.). Of the seven total participants who scored high risk, two were newly diagnosed with OSA after referral to a PCP for a sleep study with the help of the telephonic phone sessions. Education and screening demonstrated to be beneficial, resulting in positive outcomes. Project partakers were successfully able to define OSA, list risk factors, and describe how to diagnose and treat the condition. Participants who were newly diagnosed, previously diagnosed, or refused the sleep study managed to adjust modifiable risk factors over the summer such as weight loss, diet, and management of chronic conditions.

Despite the proven benefits and recommendations from the American Diabetes Association (ADA) to refer patients with type 2 diabetes to a diabetes self-management education (DSME) program, the referral rates to such programs by primary care providers (PCP) is considerably low. Only 6.8% of individuals with newly diagnosed type 2 diabetes with private health insurance have participated in DSME within 12 months of diagnosis, and only 4% of Medicare participants received DSME (Powers et al., 2020). The goal of this quality improvement project was to improve management of diabetes in primary care practice through increased awareness and engagement in DSME programs. The project was implemented at a metropolitan clinic in South Florida and included two PCP and their patients with a type 2 diabetes diagnosis. During an implementation phase, an educational session was given to each PCP with an intent to increase awareness on DSME, demonstrate its importance and recommendations by the ADA on its use, as well as educate on how and when to refer a patient with diabetes to a DSME program. Data were analyzed using descriptive statistics (percentages), and dependent sample t-test analyses. This quality improvement project resulted in improved post intervention DSME Questionnaire PCP scores, increased rates of referrals, increased rates of attendance to a DSME program and decreased HbA1c levels. These results demonstrate that an instructional intervention can positively influence PCP knowledge and standardized use of current evidence-based practice guidelines for treating adults with type 2 diabetes in a primary care setting.

Nearly 6 million Americans of all ages are living with Alzheimer’s dementia or related dementias (ADRD), and the prevalence is only expected to increase as our population ages (Gaugler, et al., 2019). Recent estimates indicate that ADRD may be moving from the sixth most common cause of death in older adults to the third, after heart disease and cancer (National Institute on Aging, [NIA] 2019). Currently there is no cure for Alzheimer’s disease or related dementias.